Cochlear implantation after bacterial meningitis in children: outcomes in ossified and nonossified cochleas

Abstract

Objective: To investigate the outcome of cochlear implantation in children with postmeningitic deafness and to compare the outcomes in ossified and nonossified cochleas.

Study design: A retrospective case note review of children with postmeningitic deafness requiring cochlear implantation.

Setting: Manchester Auditory Implant Centre--a tertiary referral center.

Patients: Children younger than 16 years with postmeningitic deafness.

Intervention: Cochlear implantation to aid auditory habilitation.

Main outcome measure: Outcomes were measured using Categories of Auditory Performance Score and the Manchester Speech and Language Development Scale.

Results: Fifty-two children underwent cochlear implantation. Patients were allocated to 2 groups--Group 1 with nonossified cochleas and Group 2 with cochlear ossification. Group 1 comprised 25 children, of whom, 22 had Categories of Auditory Performance Score of 5 or higher. Nineteen of them were able to use simple phrases of 3 words or more on the Manchester Speech and Language Development Scale. Group 2 comprised 27 children. Fourteen had partial ossification with complete standard electrode insertion in all instances. Of the 13 children with gross ossification, 3 had scala vestibuli insertion, 7 had split electrode insertion and 3 had partial electrode insertion. In this group, 20 children had Categories of Auditory Performance Score of 5 or higher. Nineteen children were able to use simple phrases of 3 words or more on Manchester Speech and Language Development Scale.

Conclusion: Children with postmeningitic deafness benefit significantly from cochlear implantation. However, the audiologic outcomes are difficult to predict, especially in the presence of cochlear ossification. Acquisition of speech and language in these children after cochlear implantation is possible even in the presence of gross cochlear ossification.